Scholarship Application
www.hennikerathletics.org
For a printable version of this form click here (PDF)
Instructions
1. Register your child (ren) at www.hennikerathletics.org (you will get a confirmation e-mail about registration)
2. Print out this form and fill it out completely then mail it or drop it off to
Henniker Town Hall
Henniker Athletics Scholarship
18 Depot Hill Road
Henniker, NH 03242
OR
E-mail it to (
rooksjarrodnh@gmail.com).
3. Scholarship must be received by the last day of sport specific registration.
4. Scholarship requests are confidential and the Henniker Athletics’ Committee Chair Person will use only the information on this application to decide if your child(ren) qualify to receive a full or partial scholarship to the specific sport program.
5. You will be notified by e-mail when a decision has been reached regarding your scholarship request as soon as possible.
Name of Child _____________________________________________
Name of Parent/Guardian_________________________ E-mail__________________________
Home Address _________________________________________________________________
Phone (day) _____________________ (evening) __________________
Sport ______________________ Number of people in your household_________
Factors you would like us to consider (attach additional sheet(s) if necessary): _______________________________________________________________________________
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